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The Annals of Thoracic Surgery, Vol 29, 265-269, Copyright © 1980 by The Society of Thoracic Surgeons
AE Baue
A potential weak link in the Belsey Mark IV partial fundoplication
operation is the placement of the plicating mattress sutures in the
esophageal muscle. During or after repair, if these sutures are tied too
tightly, if the esophagus is pulled taut beneath the diaphragm, or if the
diaphragm moves forcibly, the sutures can pull out. This causes partial or
complete disruption of the repair. The use of Teflon felt pledgets with the
mattress sutures is described (Mark V procedure). This modification seems
to give better purchase of the sutures in the muscle of the esophagus and
may help to lower the incidence of recurrence.
ARTICLES
The Belsey Mark V procedure
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